We have briefly discussed mushroom toxins
when we covered etheogenic mushrooms. It was summarized at that time that
poisonous mushrooms may have a variety of mycotoxins that may be divided into
classes, according to their chemical structures. This is a topic of interest
because
mushrooms have been gathered for eating throughout the world, for thousands of
years, and during that time many people have become ill or died when they
inadvertently consumed poisonous mushrooms. While the mushrooms that are
poisonous in a given area are generally well known, fatal mushroom poisoning may
still occur.

The knowledge as to whether mushrooms are
poisonous or edible is important for those who wish to go out to collect
mushrooms for the purpose of eating them. With a little common sense, it is
something that can be fun to do, either by yourself or as a group activity.
There are, in fact, many amateur mushroom societies throughout the country that
were formed for the purpose of going out to collect mushrooms and eating what
they have collected at the end of the day. There are many edible mushrooms that
can be found that are good to eat that are very distinct and will not be
mistaken for poisonous species. If the collector sticks to those species, there
should not be any problems. The most common reason for the occurrence of
mushroom poisoning is collecting and eating a species of mushroom that closely
resembles one that is poisonous. This is probably the most common cause of
mushroom poisoning.

A question that is often asked by the
novice mushroom collector is how can you determine if a mushroom is poisonous or
not. Often the poisonous species is referred to as a "toadstool", but
in terms of the general appearance of poisonous mushrooms do not look any
different than those that are edible. The toadstool label is just a means by
which some people refer to poisonous mushrooms. There are no generalizations
that can be made that will allow you to distinguish between what is edible and
what is not. "Fool-proof" means of making this distinction are myths
and are untrue. Some of the most common example is that a silver coin will turn
black when cooked with a poisonous mushroom, if animals are seen eating the
mushroom, then it is not poisonous, if the top layer of the cap can be peeled,
it is not poisonous and there are more. The only means by which species have
been determined to be poisonous is if somebody had eaten it and got sick and/or
died.

Used as Poison in Assassinations and Murders

That some species of mushrooms can be
fatal when ingested has long been known. On occasion this knowledge has been
utilized in as a means of assassination in order to disguise the means by which
an individual has died. Two such stories by Benjamin (1995) have been summarized
below.

The Rise of Nero as Emperor of Rome

One of the most famous of all planned murders was that of Emperor
Claudius by his fourth wife, Agrippina, The Younger (also his niece!). The story
behind this assassination, as well as the political intrigue that was present
during this period of the Roman Empire could readily have been made into a
popular mini series and/or
soap opera. Claudius became
emperor, in 41 A.D., following the assassination of his nephew Caligula, and married Agrippina, his
fourth wife, after disposing of Messalina, his third wife, for adultery. Agrippina
came into the marriage with Nero, a son from a previous marriage and wanted him
to follow Claudius as emperor. Agrippina persuaded him to adopt her son so that
Nero would be in line to become emperor. Once Nero was adopted, Agrippina
concocted a scheme to kill Claudius, which involved a number of people. Although Claudius
had a son, Brittanicus, by Messalina, and should have succeeded him as emperor,
Claudius decided to shield him from the responsibilities as heir to the throne and
promoted Nero as his successor. He believed that the political intrigue that was
taking place would eventually lead to the beginning of the fall of Rome as it
did under Caligula and that Brittanicus would then step in as emperor to save
Rome. However, this never occurred

So that Nero could become emperor, immediately, Agrippina planned
Claudius' death by preparing his favorite mushroom, Amanita caesarea ,
which
was also a
favorite of the Roman nobility. However, the
dish of mushroom was also laced with the juice of Amanita phalloides, the
Death Cap by Locusta, Claudius' trusted (or so he thought) servant. The next day
Claudius became very ill from eating A. phalloides and called Xenophon, his
personal physician, another conspirator in the crime. Because A. phalloides
did not kill Claudius immediately, Xenophon used a large dose of
colocynth, an extract obtained from Citrullus colocynthis (Bitter Apple),
which contains a toxic alkaloid. The
poison was administered as an enema so that Claudius would not detect its bitter
taste. The enema and mushroom poisoning, together, ensured the death of Claudius
and Nero's rise to emperor of Rome.

Amanita
caesarea, an edible
species.

Amanita phalloides
is quite different in appearance

A 20th. Century Insurance Scam

A more recent use took place at the beginning of the 20th.
Century, involving a Frenchman by the name of Girard, who was tried and
convicted of murder, in 1918. Girard was knowledgeable about insurance and had
some acquaintance with mushrooms. With either his wife or mistress, he would make
friends with other couples or individuals who were approximately their age. He and his wife (or mistress) would
then take
out an insurance policy in their name, by posing as the couple or individual and
name himself and his wife as the beneficiary
on the policy. Once the policy was taken out, the couple was then invited to
dinner where they were poisoned. The mushrooms used in some of the murders was Amanita
phalloides. However, bacteria, such as anthrax and typhoid were also used in
their other efforts. Unfortunately, for Girard, he became too greedy with one
of his victims. He had taken out four different insurance policies on a woman
and had collected the insurance money from three of the companies without
incident. The fourth company, however, had a suspicious physician who questioned
why such a young and healthy woman would suddenly die. When he went to perform
the autopsy, the body that he saw was not the woman that he had examined earlier
when the insurance policy was taken out. Further investigation revealed the
trail of murders that Girard and his accomplices had carried out. Girard was
sentence to death, but died of tuberculosis before his execution was carried
out. His two accomplices, his wife and mistress were sentenced to life.

Mushroom Toxins and Their Symptoms

It seemed like almost every year, when I lived in California, since
I became interested in mushrooms, somebody would inevitably die from mushroom poisoning.
The reason for this is not because every other species of mushroom is poisonous nor that
mushrooms are that difficult to identify. As I have mentioned previously, relatively few mushrooms are
poisonous and of those that are, only a handful will be fatal if consumed. We will go
over, in detail, the different types of toxins that are known to occur in mushrooms. These
toxins are summarized in the table below, with specific examples of the toxins and some
fungi that are known to have these toxins.

Mushroom Toxins, Symptoms and
Where They May Occur

Toxin
Groups

Symptoms

Fungi

I.
Cyclopeptides, e.g., Amanitoxins
and Phallotoxins

Violent vomiting, diarrhea and abdominal pain, approximately
12 hours
after consumption, which last for days. Remission of symptoms, followed by failure of
kidney and liver function, coma and usually death.

Species of Amanita in Section: Phalloideae, e.g.
A. phalloides, A. verna, A. virosa, Galerina autumnalis,
G. marginata and Conocybe filaris. It is fortunate that in
Hawai‘i only one species of Amanita occurs in section Phalloideae, A.
marmorata, and to the best of my knowledge, no reports of ingestion of
this mushroom has ever occurred in Hawai‘i.

II. Gyromitrin, e.g.,
Monomethylhydrazine (MMH)

Bloated feeling, nausea, vomiting
and diarrhea, and may feel dizzy dizzy, lethargic and exhausted, typically 6-12 hours after consumption of
mushroom. In more severe cases, signs of liver toxicity occurs 36-48
hours after consumption, and death may occur.

Species of Gyromitra, e.g.,
G. esculenta, G. infula,
and species of Helvella and Paxina. As far as I know, species
with this class of toxin do not occur in Hawai‘i.

III. Orellanine

Nausea, vomiting, and anorexia
present in most patient 12 hours to 3 days after consumption.
Evidence of renal damage occurs (burning thirst, frequent urination) after a lag
period of 3-15 days

Some species of Cortinarius, e.g.,
C. orellanus, C. speciosissimus, C. splendens. One
species of Cortinarius does occur in Hawai‘i, but whether the
toxin is present in this species is unknown.

"Little white or brown mushrooms" that grow in grassy areas. Two
common genera are Clitocybe and Inocybe. Also Omphalotus
species. The presence of mushrooms with this toxin, in Hawai‘i, is not
known.

V. Ibotenic Acid, Muscimol

Victim exhibits symptoms of
alcohol intoxication, i.e., unable to walk or walk with drunken gait,
confusion between 30 and 120 minutes of consumption.
Alternation between lethargy and hyperactivity. Nausea and vomiting may also occur if too many mushrooms
have been consumed. This is followed by a deep sleep with dreams, lasting
about two hours

Species of Amanita, e.g.
A. cokeri, A. gemmata, A. muscaria and A. pantherina
and Panaeolus campanulatus. Mushrooms with these toxins,
occurring in Hawai‘i, are infrequent and rare.

VI. Coprine (Anabuse-like Reaction)

Symptoms identical to those
produced by disulfiram (Antabuse). Hot flushes of the face and neck, metallic taste in mouth, tingling
sensation in limbs, numbness in hands, palpitations, a throbbing headache, nausea and
vomiting. Although unpleasant, consumption of mushroom is not fatal. A rather unique toxin
in that symptoms occur only if mushroom is consumed with a drink containing alcohol.
Symptoms begin approximately 30-60 minutes after consumption and will continue as long as
there is alcohol in the system.

Most commonly known from
Coprinus atramentarius.
but also known from C. insignis, C. quadrifidus and C. variegatus.
The presence of mushrooms, with this toxin, in Hawai‘i, is not known.

VII. Psilocybin and Psilocin

Variable, affecting the senses. Some of the common symptoms include
uncontrollable laughter, hallucinations, euphoria and disembodied experience.
Symptoms begin approximately 10-30 minutes after consumption.

Species from four agaric genera, Psilocybe, Panaeolus, Conocybe
and Gymnopilus. Probably common in Hawai‘i, wherever there are dung
of herbivores, i.e. cows and horses dung.

VIII. Gastrointestinal irritant,
composed of a number of unrelated compounds, which produce similar effects

Digestive upset within 30-90 minutes of consuming
mushroom. Commonest
symptoms include vomiting and diarrhea, with abdominal cramps. Symptoms clear up within
3-4 hours and complete recovery a day or so later.

You may noticed that there is are a number of redundant symptoms,
i.e. vomiting, diarrhea and abdominal cramps. Thus, these symptoms are not that useful,
but do provide an indicator that some sort of food poisoning has occurred.

Note that in the different groups of
toxin, there is not a means of determining that these mushrooms are poisonous
and that only by chemical analysis were the different toxins identified.

Group I. Phallotoxins and Amatoxins: This group of toxins is
responsible for most fatalities in mushroom poisonings. Fortunately, they occurs in only a
few taxa. The most common known species having these toxins belong in the genus Amanita,
in the section Phalloideae, and in the genus Galerina. However, it is
estimated that over 90% of mushroom fatalities is due to consumption of only one species,
Amanita phalloides. Although the latter species does not occur in
Hawaii, we do have a common species, Amanita marmorata, which belongs
in the same section of the genus. Although there have not been any incidents of
human fatalities, there have been several documented cases where pets have died
as a result of consuming this species. This species forms mycorrhizae and is
associated with trees belonging to the genus Casuarina (Iron Wood), Eucalyptus
and Melaleuca (Paper Bark). This association does not mean that the
mushrooms are necessarily growing directly at the base of these trees. The
mushrooms are usually associated with the root tips of the trees. Thus, they may
be some distance away from the tree!

The toxins involved are complex polypeptides. It was once believed
that both the phallotoxins and amatoxins contributed in poisoning the consumer, but
apparently only the latter is responsible. When phallotoxins are directly injected into
mice, they are up to ten times more lethal than cyanide. However, when taken orally, phallotoxins have no effect. Thus, it is only the amatoxins, which is
lethal, when mushrooms with Group I toxins are consumed.

In cases where A. phalloides has been consumed, the victims described
the taste as mild to quite good, which is probably why large amounts of it is normally
consumed. The amatoxin rapidly attacks the intestine, liver and kidney. However, any
discomfort from this toxin is not immediate. It may be as long as 24 hours
before any symptoms occur. This in itself makes treatment of the toxins difficult since
the victim often will not connect the sudden illness with the consumption of mushrooms
even if they should seek medical help. During this period of time the toxins are already
acting upon the cells of the liver, kidney and intestine. The victim will experience
diarrhea, profuse vomiting and abdominal pains, which usually last from four to six days.
These symptoms will then subside and the the victim will feel better and will often
believe that whatever caused the illness has passed. However, this is misleading. Because
by this time, the amatoxins will have caused collapse of kidney and liver function. The
victim will then eventually go into a coma and death usually follows. Even when death does
not occur, the illness lasts several weeks and permanent damage to the liver and kidney is
likely.

At this time, there is still not an accepted method by which
amatoxin poisoning can be treated once it has been in the victim's system for more than
several hours. By the time the symptoms manifest themselves and the victim seeks medical
help, massive damage to the kidney and liver has already been done. Thus, if an unknown
mushroom has been consumed, it is best to arrive at a correct identification of that
mushroom, immediately. Fortunately, amatoxin poisoning is rare in the United States, but
because it is rare, many doctors do not connect these symptoms with mushroom poisoning
unless their patients mention it first, and often are not experienced in the
identification of mushrooms or the effects of their toxins. Normally, a mycologist is consulted for the identification of the mushroom. If a
species containing amatoxins is identified rapidly (within an hour or two after
consumption), before it can cause any damage, vomiting is induced in the patient to empty
the stomach followed by washing out the stomach.

Group II. Gyromitrin: For many year helvellic acid was
assumed to be the cause of blood poisoning. However, we now know that the helvellic acid
is harmless. Instead a compound called monomethylhydrazine (MMH), a product produced from
hydrolyzed Gyromitrin, is responsible. MMH is used in rocket fuel and is known to be
extremely toxic. The toxin is named for the genus Gyromitra from which it was first
isolated. Species of Helvella and Paxina are also known to have this toxin.
These genera are not known to occur in Hawaii.

This Symptoms of this toxin usually appear approximately 2-12 hours
after consumption. MMH causes an initial bloated feelings, followed by nausea, and the
usual vomiting, diarrhea and abdominal cramps. Severe headaches and pain may also occur
and linger for some time. If more severe poisoning has occurred, i.e.,
individuals who have eaten large amounts of mushrooms containing Gyromitrin,
symptoms of liver toxicity will occur after between 36-48 hours. Jaundice and convulsion may occur, followed by
coma and eventually death after 2-7 days. It is estimated that Gyromitra esculenta
is responsible for 2-4% of reported mushroom fatalities. There are, however, reports that
some consumers of this species have been unaffected, but tolerance of individuals,
amount of MMH present in fungus and method of cooking may combine to cause widely varying
toxic reactions.

The actions of this toxin is somewhat similar to the cyclopeptides
in Group I in that it takes affect at the cellular level and causes liver damage. In
addition, it is hemolytic, and toxic to the central nervous system and irritates the
gastrointestinal tract. Pryridoxine hydrochloride is administered for poisoning by this
toxin.

Group III. Orellanin: Consumption of mushrooms
containing this toxin has the longest delayed reaction before the appearance of symptoms.
Nausea, vomiting, diarrhea and anorexia
present in most patient 12 hours to 3 days after consumption.
In cases where poisoning was severe, evidence of renal damage occurs (burning thirst, frequent urination)
may not occur until 3-15 days after consumption of mushroom. In mild poisoning cases, symptoms
sometimes did not appear until 10-17 days after eating the mushroom.

There is a great deal of variation with respect to the
recovery of the poisoned victim. In cases where renal damage has occurred, there
may be a period of mild renal failure followed by complete recovery. However, in
some cases, renal failure may occur and the victim will require lifelong
hemodialysis or a kidney transplant, or in some instances coma, followed by
death, will occur.

Species of Cortinarius known to have this toxin belongs to the subgenus Dermocybe.
Poisoning from
this toxin has so far been restricted to Europe where the species of mushrooms containing
orellanin occurs. In Hawai‘i, there is only one species of Cortinarius,
C. clelandii. Although it belongs to the subgenus Dermocybe, it is
not known if it has Orellanin.

Group IV. Coprine (Antabuse-like):
Coprinus
atramentarius is the most common species known to contain this toxin.
Neither this species
nor other Coprinus species with this toxin is known to occur in Hawaii. The effects of this toxin is unusual in that the physical
symptoms occur only if the mushroom is consumed with alcohol (ethanol). The consumption of
the mushroom, alone, is not toxic! Following consumption of both the mushroom and alcohol,
symptoms will begin to occur in approximately 30-60 minutes, and may occur at any time up
to five days after consumption of the mushroom.

Symptoms include hot flushes of the face and neck, a metallic taste
in the mouth, tingling sensations in the limbs, numbness in the hands, palpitations, a
throbbing headache, nausea and vomiting. The symptoms will continue as long as there is
any alcohol in the victim's stomach. With the exception of treatment to control arrhythmia
(irregular heartbeat), recovery is normally spontaneous once the body is rid of the
alcohol. This toxin is said to be antabuse-like because Antabuse
(disulfiram), is prescribed to discourage alcoholics from drinking alcoholic beverages and
has symptoms almost identical to coprine.

Group V. Muscarine: Mushrooms containing this toxin are very
nondescript and are often referred to as little white or brown mushrooms. Normally, they
are found in grassy areas and belong to two common genera, Clitocybe and Inocybe.
The former is rare and the latter does not occur in Hawaii. Thus, the occurrence of poisoning from these
mushrooms is unlikely.

Symptoms begin approximately 30 minutes to 2 hours after consumption
of toxin. The toxin stimulates the exocrine glands where sweat, saliva and tears are
produced and causes what is referred to as PSL (Perspiration, Salivation,
Lachrimation) syndrome. Other symptoms include constriction of pupils,
blurred vision, muscle spasms, diarrhea, slow heart-beat and a drop in blood pressure.
Although rare, death has been known to occur when the victim's heart stops. However, when
this has occurred, the victim usually has had a history of cardiovascular disease. The
accepted treatment is intravenous injection of atropine.

Group VI. Muscimol and ibotenic acid: Onset of
symptoms in this group may occur 30-120 minutes after consumptions. The toxins acts on the central nervous system causing
the victims to suffer from symptoms similar to alcohol intoxication. Toxin affects the
central nervous system are compared to alcohol intoxication. Onset of symptoms
usually occurs between 30-120 minutes. These symptoms include nausea and
vomiting, inability to walk or walking only with a drunken gait, alternation
between being uncontrollably active and difficult to rouse, followed by a deep
sleep with dreams, lasting about two hours. When large amounts of
A. muscaria is ingested, it often results in severe illness but even then the
victim usually recover.

The most well known species of mushroom, having
toxins in this group is Amanita muscaria (Fly Agaric). Although
neither the scientific nor common name is familiar to the layperson, this species, with
its scarlet pileus that is covered with yellowish-white spots, is the model for mushrooms
used in many children's books and greeting cards. This species forms mycorrhizae with pine
trees and is common in temperate areas of the world. However, it is recorded from
Hawaii, only on the island of Kauai. This mushroom was thought by Wasson
(1968) to be the Soma that had been used in religious ceremonies over 4,000
years ago and is known to have been used by local tribes of Siberia for their religious
ceremonies, as well. More information concerning the above connections to A.
muscaria can be seen here.

Group VII. Psilocybin and psilocin: This group of toxins is
perhaps the most well known. They are in the LSD family of hallucinogenic compounds. The toxins in this
group have a strong effect on the central nervous system. Some of the common
symptoms include uncontrollable laughter, hallucinations, optical distortions, euphoria and disembodied
experience; and some victims have reported experiencing religious or mystical
experiences. However, bad
trips may also occur causing the victim to become anxious to paranoid, and may
require considerable reassurance or, more rarely, even tranquilizers. The effects are
normally about 4-5 hours, followed by sleep. The quantity ingested, physiological
condition, personality and mood of the subject are all apparently involved in
how ingestion will affect the user.
Since as little as 5 mg. of Psilocybe cubensis can cause visual
hallucinations in 15 minutes, it is obvious that the ingestion of large quantities of some
mushrooms in this group can be fatal or cause severe toxic effects. Perhaps the most
important factor is the presence of other toxic compounds in addition to the
hallucinogenic agent in a given species. Hallucinations may be suppressed by chlorpromazine,
and convulsions by diazepam.

Toxins are found in several common genera of mushrooms: Psilocybe,
Panaeolus, Conocybe and Gymnopilus, to name a few. Species of these
mushrooms as used by Native Americans, in Mexico, for religious ceremonies have been well
studied.

Group VIII. Gastrointestinal Irritants: This is a group of
unrelated toxins. However, they all cause similar symptoms when consumed. Symptoms from
the mushroom begin 30-90 minutes following consumption. All cause varying degrees of
digestive upset. Commonest symptoms are diarrhea, vomiting and abdominal cramps. Normally,
symptoms clear up in 3-4 hours and complete recovery several days later. Some cases of
fatality have been recorded, but these are usually cases in which large quantities of
mushrooms have been consumed or if the victims were young children. There are a number of
fungi in Hawaii that have these toxins. They include Agaricus, Chlorophyllum,
Marasmius, Naematoloma, Pholiota, Scleroderma
and probably many others. Because the toxins that cause these symptoms have not
been identified, treatment has been restricted to emptying the stomach.

Summary of Toxins

The seven group of toxins can be divided into four categories
according to the matter in which they affect the consumer:

Toxins belong to Groups I, II, and III. Toxins that cause extensive
cellular damage, followed by physical symptoms, which appear only after cellular damage
has occurred and is often no longer treatable.

Toxins belong to Groups IV and V. Toxins affect the autonomic system,
with symptoms appearing shortly after consumption or when the appropriate substrate enters
the system.

Toxins belonging to Group VIII. The unidentified toxins, which cause
gastrointestinal discomfort as soon as they are consumed.

There is a lot of information in this
lecture, especially with respect to details of symptoms. What you should
emphasize are the specific terms and questions below. Note that you have had
several of the terms in previous lectures:

Some Poisonous Mushroom Terms

Amatoxins:
One of two categories of Class I toxin that may be lethal when consumed.

Coprine: Toxin that affects the
consumer with symptoms only if alcohol (ethanol) is consumed with the toxin.
Symptoms include hot flushes of the face and neck, a metallic taste in the
mouth, tingling sensations in the limbs, numbness in the hands, palpitations, a
throbbing headache, nausea and vomiting. The symptoms will continue as long as
there is any alcohol in the victim's stomach.

Ibotenic acid: One of the two
main toxins in Class VI toxins. The other being Muscimol. This toxin is the
weaker of the two. Toxin affects the central nervous system are compared to
alcohol intoxication. Onset of symptoms usually occurs between 30-120 minutes.
These symptoms include nausea and vomiting, inability to walk or walking only
with a drunken gait, alternation between being uncontrollably active and
difficult to rouse, followed by a deep sleep with dreams, lasting about two
hours.

Muscimol: One of the two main
toxins in Class VI toxins. The other being Ibotenic acid. This toxin is much
more potent than the latter. Toxin affects the central nervous system are
compared to alcohol intoxication. Onset of symptoms usually occurs between
30-120 minutes. These symptoms include nausea and vomiting, inability to walk or
walking only with a drunken gait, alternation between being uncontrollably
active and difficult to rouse, followed by a deep sleep with dreams, lasting
about two hours.

Phallotoxins: One of two
categories of Class I toxin. It was once believed that the phallotoxins
contributed in poisoning the consumer, but apparently only the amatoxins are
responsible. When a phallotoxins are directly injected into mice, they are up to
ten times more lethal than cyanide, but when taken orally, phallotoxins
have no effect.

Psilocin: The toxin has a strong
effect on the central nervous system. Some of the common symptoms include
uncontrollable laughter, hallucinations, optical distortions, euphoria and
disembodied experience; and some victims have reported experiencing religious or
mystical experiences. Symptoms begin approximately 10-30 minutes after
consumption. The effects are normally about 4-5 hours, followed by sleep.

Psilocybin: The toxin has a
strong effect on the central nervous system. Some of the common symptoms include
uncontrollable laughter, hallucinations, optical distortions, euphoria and
disembodied experience; and some victims have reported experiencing religious or
mystical experiences. Symptoms begin approximately 10-30 minutes after
consumption. The effects are normally about 4-5 hours, followed by sleep.

Questions to Think About

What
are some of the common symptoms that most of the classes of toxins have when
consumed?

What
class of toxins is responsible for most of the mushroom fatalities in the
world? What species of mushroom is responsible for over 90% of all
fatalities?

Why
is the class of toxins in question #2 difficult to associate with mushroom
poisoning?

What
is an unusual property of the coprine toxin?

What
are the toxins that cause hallucinations?

The
class of toxins labeled gastrointestinal toxins is all made up of a number
of different toxins, some of which are unknown. However, there is an
accepted treatment that is usually successful. What is usually done for
mushroom poisoning in this class of toxin?

There
are a number of mushrooms that are poisonous. How can you determine which
ones are poisonous and which are not?